Tag: spinal injections

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PROS AND CONS OF SPINAL INJECTIONS FOR PAIN?..

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As I am sure my readers know I have had several different types of spinal injections from epidurals to facet joint injections and even a life-threatening episode with one particular injection. But what are the pros and the cons of these types of injections which have given you time-limited pain relief?

The facet joint injection provides important information for your doctor and can also give you pain relief. Why do I have to have an injection in the facet joint? The procedure is designed to prove if the facet joint is causing your pain by placing a temporary medication to reduce discomfort in the joint.

The pros are that it provides a direct management for joint pain and inflammation. It provides faster pain relief and relieves moderate to severe pain. Steroid injections also provide faster pain relief than oral forms of anti-inflammatory drugs. Joint injections allow the drug to be absorbed in the blood stream faster than oral medications. Making pain receptors less sensitive, in turn sending fewer pain signals through the nerves

There are no stitches or open wounds to deal with, and because of this, you have an extremely small risk of infection. Overall, facet joint injections are considered a very safe treatment.

You may get between three weeks and three months’ pain relief from a steroid joint injection, though this varies. You can have the injections every three months if you need them. Generally, it’s best not to have more than four steroid joint injections in a year into any one joint. This is because there’s a chance any more could damage your joint.

The waiting list on the NHS for any spinal injections is long but having them done privately is not cheap. It varies across the UK from £1,200 in the far north to £2,043 in the south.

The cons are that steroids have various side-effects. Age can also become a factor with facet joint injections. As you age, your facet joint becomes more damaged. This makes the injection more technically difficult because the joint is too small and maybe tighter. You may also grow small bones called osteophytes, which you do not normally see on an X-ray.

You could have an allergic reaction or cause bleeding although this is usually only a risk with patients who are on blood thinners.

Minor infections occur in less than 1% to 2% of all injections. Severe infections are rare, occurring in 0.1% to 0.01% of injections.

You could get discomfort at the point of the injection or worsening of pain symptoms. And while very rare, damage to the spinal cord or spinal nerves can occur from direct trauma from the needle, or secondarily from infection, bleeding resulting in compression, or injection into an artery causing blockage.

Have you had any spinal injections and if so how long did the pain relief last? I would love to hear from anyone who has had this treatment either on the NHS or privately as I am trying to get as much information as possible to write a much bigger article on it.

For me personally I enjoy every second of my pain free time after my injections and would not hesitate accepting any being offered to me.

Source: Northampton Chiropractor, Spine Health BUPA Private Health

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THE ANTIBIOTIC JAB FOR BACK PAIN…

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The Daily Mail wrote that Doctors in the UK are testing whether a one-off jab of a new drug known as PP353 can ease — and even cure — the chronic lower back pain that affects millions.

The antibiotic kills bacteria that normally cause acne but have also been found hiding in the damaged spinal discs of patients with back pain.

Three people have already been treated, and one has said that a ‘dramatic’ reduction in pain means he can go swimming again.

Common causes of back pain include slipped discs, arthritis and spinal stenosis (where bones press on nerves) but there are growing evidence bacteria also play a role.

In a landmark 2013 study, Danish researchers found that in up to 40 per cent of patients with slipped discs, the damaged discs were infected with Cutibacterium acnes bacteria.

The discs are spongy pieces of tissue that sit between and cushion the bones of the spine. When one slips or herniates, most commonly due to age-related wear and tear, part of its softcore bulges out and can press on nearby nerves.

Cutibacterium acnes normally causes acne but is also found in the mouth and can get into the bloodstream as a result of poor dental hygiene.

Slipped discs grow small blood vessels as part of the repair process, and it’s thought this is how the bacteria enter the disc explained The Daily UK News.

They then produce an acid that damages the surrounding bones, irritates the nerves and causes inflammation, leading to pain.

Studies have shown that oral antibiotics can help ease the pain. But much of the drug is broken down before it reaches the spine, so the tablets have to be taken for at least three months to be effective. 

Such prolonged use raises the risk of side effects including diarrhoea, abdominal pain and loss of appetite, as well as concerns about antibiotic resistance, where bacteria develop the ability to defeat drugs meant to kill them.

The new treatment, developed by Kent-based Persica Pharmaceuticals, involves injecting the PP353 antibiotic into the disc. This maximises the amount of the drug that reaches the bacteria, allowing patients to be treated with a single injection, in turn reducing the risk of side effects and antibiotic resistance.

Once injected, PP353 solidifies, which ensures it stays within the disc, stopping the bacteria from growing and causing pain.

A preliminary trial at hospitals in Preston and Coventry found it to be safe and well tolerated. A larger trial, involving 40 patients, is now underway.

Michael McNicholas, a consultant orthopaedic surgeon at Liverpool University Hospitals NHS Foundation Trust, said that the successful treatment of lower back pain with antibiotics could make surgery for it obsolete.

He added: ‘This groundbreaking work could transform life for millions of patients suffering from chronic back pain.’

Let’s hope the 40 trial patients now undergoing this procedure have great pain relief as lower back pain at the moment is reaching epidemic level due to Covid-19.

Source: The Daily UK News The Daily Mail

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BPB ALERT – ENDOSCOPIC SPINAL SURGERY THE BEST ROUTE FOR LOWER BACK PAIN…

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Deseret News wrote that endoscopic spinal surgery need not be only for the physically fit people struggling with severe pain issues relating to spinal compression. This type of surgery expands opportunities for certain patients, those that are older or a little bit frailer and for whom a small surgery and quicker recovery makes sense, particularly when doing an open procedure has greater risks.

Endoscopic spinal surgery is limited in scope to primarily disc herniations and the narrowing of the spinal cord, which is essentially like an open procedure but done with smaller tools, which means it takes longer. With an endoscope, you don’t need to remove things to see, and you can achieve a decompression of the spine that removes less bone.

Advantages to having endoscopic spinal surgery are that it is done under local anesthetic with a skin incision of only 5-10mm length, which is significantly less invasive than open spine surgery. The pain relief is immediate or within a few hours after the surgery. And, it allows the patient to return home within 24 hours after the operation so much less risk of developing any complications.

The BMI Healthcare group which list MISS (minimally invasive spinal surgery) write about MISS as minimally invasive spinal surgery that early treatment is the most practical, successful and cost-effective solution to back pain. Back pain is caused by a number of different conditions, many of which can be diagnosed and treated by our team of highly specialised consultant surgeons and physiotherapists.

MISS allows treatment for a greater variety of conditions for patients of a wider age and infirmity range unlike previously where none could be offered. Minimally invasive spine surgery is very promising and has the distinct advantage of all endoscopic surgery (avoiding soft tissue and bone trauma). It gives the patient a much faster recovery, with a reduced surgical risk.